Final report of the FOPE II Financing of Pediatric Education Workgroup

Some of the challenges of financing pediatric medical education are shared with all medical education; others are specific to pediatrics. The general disadvantage that funding of graduate medical education (GME) is linked to reimbursement for clinical care has uniquely negative consequences for free standing children's hospitals because they therefore receive little Medicar e GME support. This represents both a competitive disadvantage for such hos pitals and an aggregate federal underinvestment in children's health care t hat now amounts to billions of dollars. The need to subsidize medical stude nt and subspecialty education with clinical practice revenue jeopardizes bo th activities in pediatric departments already burdened by inadequate reimb ursement for children's health care and the extra costs of ambulatory care. The challenges of funding are complicated by rising costs as curriculum ex pands and clinical education moves to ambulatory settings. Controversies ov er prioritization of resources are inevitable. Solutions require specificat ion of costs of education and a durable mechanism for building consensus wi thin the pediatric community.